Evolution of an inguinal hernia surgery practice

Background-Inguinal hernia surgery has undergone numerous advances in the l ast few years. This study analysed the changes in the practice of one surge on in a district general hospital over a seven year interval. The effect of changing from Bassini to Lichtenstein repair in 1994 was evaluated. Methods-The study involved two parts: first a search of a computerised data base of inguinal hernia procedures, and second, postal audits of men who ha d an inguinal hernia repair in 1993 and 1994 with outpatient follow up for those with a possible recurrence. Results-A total of 1037 hernias were repaired over the seven years. There w as an increase in the proportion of day cases from 18% to 70% and the numbe r of operations performed under local anaesthetic rose from 1% to 45%. The postal audits had response rates of 79% (1993) and 66% (1994). Some 5/98 (5 %) recurrent hernias were identified from the 1993 (Bassini) patients compa red with 1/67 (1.5%) from the 1994 (Lichtenstein) cohort. Conclusion-Lichtenstein hernia repair can be performed safely as a day case using local anaesthetic in the majority of patients and appears to have a lower recurrence rate than Bassini repair.